Pain Centers of Wisconsin - Beaver Dam, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PAIN CENTERS OF WISCONSIN - BEAVER DAM, LLC

Practice address

1701 N Spring St
Beaver Dam, WI 53916-1178

Phone

(414) 325-7246

Fax

(414) 325-3770

NPI assigned

May 23, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Vishal Lal

Title

Ceo

Phone

(414) 325-7246

Specialties & licenses 1

Addresses

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Beaver Dam Community Hospitals Inc

  • Pharmacy
  • Beaver Dam, WI
  • NPI 1295771780

  Member Of

  NPD member

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1337731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477267200000",
    "number": "1437419561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 W LOOMIS RD",
            "address_2": "STE 300",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212057",
            "telephone_number": "414-325-7246",
            "fax_number": "414-325-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N SPRING ST",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539161178",
            "telephone_number": "414-325-7246",
            "fax_number": "414-325-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN CENTERS OF WISCONSIN - BEAVER DAM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-23",
        "last_updated": "2016-10-24",
        "status": "A",
        "authorized_official_last_name": "LAL",
        "authorized_official_first_name": "VISHAL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "414-325-7246"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert A Oines, DDS
• Kenneth V Ostermann, M.D.
• Mary F Ostermann, M.D.
• Pamela Owen Hiley, LPN
• Pain Centers of Wisconsin - Beaver Dam, LLC
• Paul Anthony Palmer, MD
• Abigail L Paspalofski, DPT
• Tara Passow, M. D.
• William Perego
• Bethany N Perry, APNP

• Ambulatory Surgical Clinic/Center in Beaver Dam, WI
• Providers in Beaver Dam, WI by specialty
• Ambulatory Surgical Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.